ULTRASOUND Messages for March, 2008: Re: Important PBS series in March

Re: Important PBS series in March

From: James Smeltzer

James.Smeltzer@wellstar.org

Mon Mar 10 10:43:24 2008

My Dad, last christmas, at the age of 84 reaffirmed his living will statement to me personally that he wanted EVERYTHING done if there was ANY CHANCE of recovery. I said it didn't make much sense but we would respect his wishes. Each of my brothers had the same conversation with him independently. Feb he was in septic shock (from medical malpractice) and four system failure and we all agreed that we did not want ICU & full court press but our hands were tied by his clear preference.

Six weeks of excellent ICU care (& $250000) later he woke up from everything and said he wanted to die. We were acting to respect his wishes, but doing something we knew was wrong. This sort of thing happens every day, only it is usually a guilty family that wants "everything done" for grandpa who they haven't seen as much as they thought they ought to - so to make amends they are going to torture the poor guy for days or weeks before saying goodbye.

What I tell the families of pre-viable babies: Intensive care with a reasonable expectation of a positive outcome is good medicine. Intensive care with no reasonable expectation of a positive outcome is TORTURE. At least I know that Dad asked for it with a clear living will, reaffirmed it at his last opportunity and actually made it through what should have killed him four times over - justifying what the docs and we started with - that there was SOME chance. But I still feel sad that we wasted all those resorces just so he could get to a point where he was ready to say good-bye - not a total waste, come to think of it, but it still hurts to know what he went through.

As a culture, our fear of death is behind much of this craziness....

And the irony is that the fear is what prevents us from living. I am learning to go over curbs on my mountain bike. If you go at it with the expectation of doing it you can, if not then not. I just got down coming up on an 8" curb and going right over it. I pedaled down to the drugstore and chickened at the last second on the same size curb - forgot to clip out too, just fell over, skinned my knee. >>> Joe <forcep@intercom.net> 3/9/2008 1:38 PM >>>
"If we as retired workers didn't have to worry about end-of-life medical decisions---" . Then quit demanding CAB's at age 80. What is the figure? Over 70% of health care spent on those over 70 with life expectency of less than 10 years? Joe C

BettyTX wrote: > What is their population versus ours? How long have they had that
> system? How cohesive is the population and what do they see as their
> disparities in their population? Do they have the same class warfare
> mindset as is prevalent in the USA?
>
> It's much easier to do if it is all you know. It is also much easier to
> do on a smaller scale. Regardless of how pretty and utopian it sounds it
> would be a logistical nightmare to implement in the USA because of the
> sheer size of our population. We may end up with a public/private
> system, but I don't believe we will ever end up with a full on public
> system ala Denmark. If by chance we do, I believe it will be long after
> my lifetime.
>
> And no, we can't take it with us, but I would like to leave something to
> my children other than debt and taxes.
> --------------------
>
> --------------------
> All good, logical questions. I agree the logistics of a new system would
> --------------------
> be mind-boggling, but just Part D of Medicare is pretty mind-boggling! I
> figured up our Medicare payments, supplemental insurance payments, Long
> Term Care insurance payments, dental, optical, prescription and doctor
> co-pay and the healthcare exams that our insurance and Medicare do not
> cover and then added that and our taxes to our after-tax income and
> divided it in half, and the result was not much different.
>
> If we as retired workers didn't have to worry about end-of-life medical
> expenses (which can wipe out a pretty hefty estate rather quickly), I
> can see that we probably would leave more to our kids with the 50%
> bracket than with what we have now. I suspect a brand new program will
> have to be implemented in segments over several years. Also, one
> call-in to C-Span said she was a Baby Boomer and she wanted to remind
> people that the Baby Boomers will not live forever and that when that
> generation dies, the population bulge will revert to previous numbers.
>
> Of course, if one remains healthy all of his/her life and has no major
> illnesses and just drops dead suddenly, the current way may leave more
> to heirs.
>
> This message is from a retired person, but one who is even more
> interested in health issues than ever and the policies concerning them:
>
> Betty

-- James S. Smeltzer, MD, FACOG, SMFM Consultant, Maternal Fetal Medicine Wellstar Physicians' Group Northwest Women's Care 787 Campbell Hill St Marietta GA 30060 James.Smeltzer@wellstar.org VM 678-290-3035 Off 770-528-0260 Page 404-318-3451

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